Correlation of Radiological and CSF Patterns in Adults with Meningitis: A Retrospective Analysis from a Tertiary Care Hospital in Peshawar

Abstract

Objective:  This study aimed to assess the correlation between radiological imaging findings and cerebrospinal fluid (CSF) parameters in adult patients with bacterial and tuberculous meningitis, to identify distinct diagnostic patterns that could enhance differentiation and improve clinical management.

Materials and Methods:  A total of 97 cases, comprising individuals aged fourteen years and above, were retrospectively examined over a twelve-month timeframe following a confirmed diagnosis of meningitis. Data included clinical presentation, CSF analysis, and imaging findings from MRI and CT scans. Statistical tests, including chi-square, were used to evaluate the association between radiological and CSF patterns.

Results:  Tuberculomas were exclusively associated with tuberculous meningitis (p = 0.013), while infarcts were more prevalent in bacterial cases (p = 0.002). Hydrocephalus was observed more frequently in bacterial meningitis, but it was not statistically significant (p = 0.155). CSF profiles highlighted elevated protein levels and lymphocyte dominance in tuberculous cases, contrasting with neutrophilic inflammation and variable glucose levels in bacterial meningitis. The integration of radiological and biochemical data enhanced diagnostic precision.

Conclusion:  This study highlights the importance of combining radiological imaging with CSF analysis in diagnosing meningitis. The findings provide valuable insights into local patterns, improving differential diagnosis and patient outcomes. Prospective studies are recommended to validate these findings and refine therapeutic protocols.